The Spencer County Fiscal Court on Dec. 1 agreed to reconcile an ambulance‑provider Medicaid overpayment for FY2021 and to return funds to providers, and commissioners discussed an announced increase in medical‑control fees from University of Louisville Health.

County staff reported reconciliation figures showing the county must return $9,840.67 to payers and expects to receive $6,300 from other reimbursements; the court approved the reconciliation and authorization to issue the checks.

Separately, EMS leadership reported that UofL Health — which provides medical control and online physician direction through a designated medical director — had notified the county of a proposed roughly 14% fee increase. Commissioners and staff discussed limited local alternatives, radio/coverage limitations that make switching providers difficult, and liability concerns tied to medical direction. Robert (EMS staff) said the county could seek competitive pricing and that rural counties in Kentucky use a variety of arrangements (U of L, UK or regional hospitals) depending on coverage and radio capability.

Commissioners asked staff to gather comparative contracting data and pricing and to report back before any contract changes are finalized. No contract award or rate change was approved at the meeting.

Provenance: Ambulance reconciliation recorded in the financial/reports section; medical‑control discussion occurs in the EMS presentation material (topic introduction SEG 1038; topic finish SEG 1434).